Pediatric Infectious Mononucleosis

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What is infectious mononucleosis?

Infectious mononucleosis, also known as mononucleosis, mono, or glandular fever, is characterized by swollen lymph glands and chronic fatigue.

What causes infectious mononucleosis?

Infectious mononucleosis is either caused by the Epstein-Barr virus (EBV) or the cytomegalovirus, both of whom are members of the herpes simplex virus family. Consider the following statistics:

Most adults in the United States have been exposed to the Epstein-Barr virus, which is a very common virus. When children are infected with the virus, they usually do not experience any noticeable symptoms. However, uninfected adolescents and young adults who come in contact with the virus may develop infectious mononucleosis in nearly 50 percent of exposures.

The cytomegalovirus is actually a group of viruses in the herpes simplex virus family that often cause cells to enlarge. About 80 percent of adults who are infected with the cytomegalovirus usually do not develop symptoms.

The Epstein-Barr virus (EBV) may cause infectious mononucleosis in adolescents and young adults. However, even after the symptoms of infectious mononucleosis have disappeared, the EBV will remain dormant in the throat and blood cells during that person's lifetime. The virus can reactivate periodically, however, usually without symptoms.

What are the symptoms of infectious mononucleosis?

Mononucleosis usually lasts for one to two months. The following are the most common symptoms of mononucleosis. However, each individual may experience symptoms differently. Symptoms may include:

Fever

Swollen lymph glands in the neck, armpits, and groin

Constant fatigue

Sore throat due to tonsillitis, which often makes swallowing difficult

Enlarged spleen

Liver involvement, such as mild liver damage that can cause temporary jaundice (yellowing of the skin, eyes, and mucous membranes)

Once a person has had mononucleosis, the virus remains dormant for the rest of that person's life. Once a person has been exposed to the Epstein-Barr virus, a person is usually not at risk for developing mononucleosis again.

The symptoms of the mononucleosis may resemble other medical conditions. Always consult your child's physician for a diagnosis.

How is infectious mononucleosis diagnosed?

In addition to a complete medical history and physical examination of your child, a diagnosis of mononucleosis is usually based on reported symptoms. However, diagnosis can be confirmed with specific blood tests and other laboratory tests, including:

White blood cell count

Antibody test

How is infectious mononucleosis spread?

Mononucleosis is often spread through contact with infected saliva from the mouth. Symptoms can take between four to six weeks to appear and usually do not last beyond four months, according to the Centers for Disease Control and Prevention (CDC). Transmission is impossible to prevent, according to the CDC, because even symptom-free people can carry the virus in their saliva.

Treatment

Alleviating symptoms of mononucleosis may include the following:

Rest for about one month (to give the body's immune system time to destroy the virus)

Children's Team

Providers

Departments

Our Division of Infectious Diseases is the major referral center for infectious disease in the Washington, DC, area, helping thousands of patients each year, and actively promoting prevention through community outreach and education.

Emily's Story

"The social worker was great. She held a class for Emily and the other needle phobic kids on the floor. This class allowed the kids to place IV's in stuffed dolls and have some control over the care of someone else, even if it was just a doll."